PURPOSE: To prospectively analyze whether cross-linked hyaluronan gel reduces the mean rectal dose and acute rectal toxicity of radiotherapy for prostate cancer. METHODS AND MATERIALS: Between September 2008 and March 2009, we transperitoneally injected 9 mL of cross-linked hyaluronan gel (Hylaform; Genzyme Corporation, Cambridge, MA) into the anterior perirectal fat of 10 early-stage prostate cancer patients to increase the separation between the prostate and rectum by 8 to 18 mm at the start of radiotherapy. Patients then underwent high-dose rate brachytherapy to 2,200 cGy followed by intensity-modulated radiation therapy to 5,040 cGy. We assessed acute rectal toxicity using the National Cancer Institute Common Terminology Criteria for Adverse Events v3.0 grading scheme. RESULTS: Median follow-up was 3 months. The anteroposterior dimensions of Hylaform at the start and end of radiotherapy were 13 +/- 3mm (mean +/- SD) and 10 +/- 4mm, respectively. At the start of intensity-modulated radiation therapy, daily mean rectal doses were 73 +/- 13 cGy with Hylaform vs. 106 +/- 20 cGy without Hylaform (p = 0.005). There was a 0% incidence of National Cancer Institute Common Terminology Criteria for Adverse Events v3.0 Grade 1, 2, or 3 acute diarrhea in 10 patients who received Hylaform vs. a 29.7% incidence (n = 71) in 239 historical controls who did not receive Hylaform (p = 0.04). CONCLUSIONS: By increasing the separation between the prostate and rectum, Hylaform decreased the mean rectal dose. This led to a significant reduction in the acute rectal toxicity of radiotherapy for prostate cancer. (c) 2010 Elsevier Inc. All rights reserved.
PURPOSE: To prospectively analyze whether cross-linked hyaluronan gel reduces the mean rectal dose and acute rectal toxicity of radiotherapy for prostate cancer. METHODS AND MATERIALS: Between September 2008 and March 2009, we transperitoneally injected 9 mL of cross-linked hyaluronan gel (Hylaform; Genzyme Corporation, Cambridge, MA) into the anterior perirectal fat of 10 early-stage prostate cancerpatients to increase the separation between the prostate and rectum by 8 to 18 mm at the start of radiotherapy. Patients then underwent high-dose rate brachytherapy to 2,200 cGy followed by intensity-modulated radiation therapy to 5,040 cGy. We assessed acute rectal toxicity using the National Cancer Institute Common Terminology Criteria for Adverse Events v3.0 grading scheme. RESULTS: Median follow-up was 3 months. The anteroposterior dimensions of Hylaform at the start and end of radiotherapy were 13 +/- 3mm (mean +/- SD) and 10 +/- 4mm, respectively. At the start of intensity-modulated radiation therapy, daily mean rectal doses were 73 +/- 13 cGy with Hylaform vs. 106 +/- 20 cGy without Hylaform (p = 0.005). There was a 0% incidence of National Cancer Institute Common Terminology Criteria for Adverse Events v3.0 Grade 1, 2, or 3 acute diarrhea in 10 patients who received Hylaform vs. a 29.7% incidence (n = 71) in 239 historical controls who did not receive Hylaform (p = 0.04). CONCLUSIONS: By increasing the separation between the prostate and rectum, Hylaform decreased the mean rectal dose. This led to a significant reduction in the acute rectal toxicity of radiotherapy for prostate cancer. (c) 2010 Elsevier Inc. All rights reserved.
Authors: M E Schutzer; P F Orio; M C Biagioli; D A Asher; H Lomas; D Moghanaki Journal: Prostate Cancer Prostatic Dis Date: 2015-02-17 Impact factor: 5.554
Authors: Raymond B King; Sarah Os Osman; Ciaran Fairmichael; Denise M Irvine; Ciara A Lyons; Ananth Ravi; Joe M O'Sullivan; Alan R Hounsell; Darren M Mitchell; Conor K McGarry; Suneil Jain Journal: Br J Radiol Date: 2018-01-23 Impact factor: 3.039
Authors: Danny Y Song; Klaus K Herfarth; Matthias Uhl; Michael J Eble; Michael Pinkawa; Baukelien van Triest; Robin Kalisvaart; Damien C Weber; Raymond Miralbell; Theodore L Deweese; Eric C Ford Journal: Int J Radiat Oncol Biol Phys Date: 2013-02-13 Impact factor: 7.038
Authors: Esther Mayrata; Jose Maria Espinosa; David Büchser; Francisco Casquero; Fernan Suárez; Alba González; Pablo Minguez; Jose Fernando Pérez; Iñigo San Miguel; Jon Cacicedo; Alfonso Gómez-Iturriaga Journal: J Contemp Brachytherapy Date: 2021-02-18